By Karen Freifeld and Rich McKay

NEW YORK (Reuters) – An autopsy of the financier Jeffrey Epstein, who died in an apparent suicide while awaiting trial on sex trafficking charges, found his neck had been broken in several places, the Washington Post reported late on Wednesday.

Such injuries can occur to people who hang themselves or who are strangled. The newspaper cited unidentified sources familiar with the autopsy’s results.

Epstein, a multi-millionaire and convicted sexual offender, was found dead in his jail cell in New York City on Saturday. The circumstances of his death are under investigation, and it was unclear when a report of the autopsy would be made public.

A representative of the New York Medical Examiner’s office did not immediately respond to requests for comment.

It was unclear if the medical examiner had made a final determination into how Epstein died. NBC News cited an unnamed source as saying Epstein’s body was claimed by an associate.

Dr. Zhongxue Hua, the Bergen County medical examiner in New Jersey, said a neck fracture was atypical in a suicide, but warned not to jump to conclusions.

“It’s unusual to have a neck fracture,” Hua said. “But the first question to address is when did it occur.”

If Epstein’s neck fracture was fresh, Hua said, then “at a minimum, it’s a very unusual suicide.”

Hua said he was familiar with Barbara Sampson, the chief New York medical examiner, and Michael Baden, a doctor who observed Epstein’s autopsy.

“The case is in two sets of top-notch hands,” he said. “Both have the highest integrity.”

Epstein, 66, who once counted Republican President Donald Trump and Democratic former President Bill Clinton as friends, was found unresponsive in his cell on Saturday morning, according to the Federal Bureau of Prisons.

A source told Reuters previously that he was found hanging by the neck.

Epstein had pleaded not guilty in July to charges of sex trafficking involving dozens of underage girls between 2002 and 2005. Prosecutors said he recruited and paid girls to give him massages, which became sexual in nature.

Attorney General William Barr has said the criminal investigation into any possible co-conspirators would continue.

Barr, whose agency oversees the Bureau of Prisons, has also demanded an investigation into Epstein’s death and ordered the removal of the prison’s warden.

The disgraced financier had been on suicide watch at the Metropolitan Correctional Center in lower Manhattan but was taken off prior to his death, according to a source who was not authorized to speak on the matter.

Epstein was alone in a cell when he was found hanging there.

At the MCC, two jail guards are required to make separate checks on all prisoners every 30 minutes, but that procedure was not followed overnight, the source said.

Separately, a team at the jail on Wednesday began an “after-action” review, which is normally triggered by significant events such as a prominent inmate’s death, a person familiar with the matter said.

(Reporting by Rich McKay in Atlanta and Karen Freifeld in New York; Additional reporting by Sarah N. Lynch; Editing by Darren Schuettler and John Stonestreet)